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Coughs in children

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read
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A cough is the most common illness in a child. At times it can sound very bad but it is not always a sign that there is anything very concerning. 

A cough can be caused by viruses like COVID-19, colds or flu, bacteria that cause chest infections or pneumonia, or by allergies or asthma. Typically viral coughs last for 1 to 2 weeks, resolving on their own; they can last longer but are hopefully improving in that time and your child should soon be well.

Doctor’s advice

Are there different types of cough?

Yes, there certainly are, and certain coughs are characteristic of particular infections or conditions.

We’ll take you through them so you can work out the cause of your child’s cough.

A barking cough is caused by swelling in the upper airway- this goes down to the pharynx and larynx, deep in the throat. Croup is usually the culprit of a barking cough, and it usually affects children under 3 years old. It commonly starts in the middle of the night and the child can develop a noisy alarming breathing called stridor.

Whooping cough is caused by a bacterial infection of the airways called pertussis. The child can have spells of back-to-back coughing without being about to take a breath. After this they take in a deep breath that makes a whooping sound. They can also have a temperature with this cough. The US’s childhood vaccine program protects against pertussis.

A wheeze is a high-pitched whistling sound on taking a breath, and if this accompanies a cough, it indicates the lower airways are swollen. This can happen in bronchitis, often called viral-induced wheeze, or with asthma.

Most coughs get worse at night because the mucus from the nose drips to the back of the throat when the child lies down, irritating the lining of the airways and causing them to cough. This can happen in colds, flu, chest infections, and asthma.

Asthma often makes coughs worse in the early hours and morning, and children may feel a tightness across their chest that is relieved by their rescue inhaler (albuterol).

Any more causes?

A daytime cough may be prompted by cold air or allergens getting into the lungs.

The common cold can cause a cough with a mild fever. If the temperature stays persistently high then it could be pneumonia, especially if the child is breathing fast or is lethargic. 

A cough can cause vomiting if a child coughs so much that it triggers their gag reflex at the back of their throat and makes them vomit. This is nothing to worry about, unless the vomiting continues.

A persistent cough will last for weeks, and may be caused by picking up back-to-back viruses, especially if you notice a runny or blocked nose and possibly conjunctivitis. Asthma and allergies can cause an ongoing cough as well. If it lasts longer than 3 weeks, it’s worth speaking to their doctor.

How is a cough treated in children?

Most coughs are treated with over-the-counter medication. If your child is under 6 years, we recommend speaking with your pharmacist. If they are 6 or over, you can get syrup for chesty or dry coughs, depending on how they sound. Acetaminophen can help with any associated pain or fever.

If you think an allergy is causing the cough, you can give your child antihistamine syrup.

Most coughs should resolve within 2 weeks. If the cough doesn’t resolve after 2 to 3 weeks or it is getting worse, you should contact your doctor.

If your doctor suspects asthma, they might give a trial of an albuterol inhaler to see if that helps with the cough and any other associated symptoms, although asthma is not usually diagnosed until the child is over 5 years.

When should I take them to a doctor?

If your child’s cough lasts longer than 2 weeks or is worsening, they are coughing up green/brown phlegm, or complaining of pain in the chest then you should speak to a doctor. If your child is breathing differently or making noises when they breathe it is important to speak to someone right away.

It is also advised to go to the emergency department if they have a very high fever, not improving with acetaminophen, reduced eating or drinking, or they are not their usual playful self, crying or lethargic. If their lips, face or mouth are going blue, they are showing signs of dehydration or they are struggling to breathe, call 911 for an ambulance.

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Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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